3() cases of open angle glaucoma with cataract who underwent phacoemulsitlcation, PI\'IMA phaco profile IOL implantation and trahcculectomy through same incision were critically evaluated. The mean controlled. preoperative intra ocular pressure was 20 mm of IIg (range 18 to 35 mm ofHg) by aplanation method. Mean post operative pressure after 12 months was 13 mm of Hg (range 11 to 22 mm of IIg) intra operative hyphaema, post operative uveitis were noted problems. Periodic, post operative optic disc and field evaluation remained static in 66% cases. Visual acuity of 6/12 or better was achieved in 6()% cases. Failure to restore glaucoma control without medication was seen in 13.3% cases after 9-12 months. The combined phacotrabeculectomy is an effective single step technique of managing concurrent glaucoma with cataract. MJAFl2001; 57 : 207-209

Phacoemulsification surgery is rapidly emerging as accepted latest surgical technique for the management of cataract. Retrospective analysis of first fifty cases of phacoemulsification surgery performed in our setup were critically evaluated to assess efficacy and adaptability of this procedure in Armed Forces setup. Results of initial twenty five cases were compared qualitatively with subsequent cases. Equipment settings, operative constraints, post-operative complications, effects on induced astigmatism, visual outcome and patient's rehabilitation were critically evaluated. Corneal striate, iris chaffing, posterior capsular rent were noted initial problems. Induced astigmatism was ranging between 0.5 to 1.0 Dioptre with early decay and complete stabilisation within four weeks. Inspite of excellent visual outcome, complex technique, steep and long learning curve restricts its application to institutional setup.

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Diabetic macular oedema, focal or diffuse, is primarily responsible for visual loss in cases of diabetic retinopathy. When to start photocoagulation in such cases has often been debatable. Over a 3 year period, 80 eyes of 80 patients were subjected to argon green macular grid photocoagulation in a randomized clinical study keeping the other eye (80 eyes) as controls in patients with diabetic macular oedema. It was observed that in 5 per cent of such eyes the vision did improve while in 6.3 per cent of patients deterioration of vision was present as compared to 16.3 per cent in control group. It is concluded that laser photocoagulation has a definite role in arresting the progression of diabetic maculopathy and early intervention should be resorted to in case of clinically significant macular oedema.

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